Impact of Hemoglobin-to-RDW Ratio and Vitamin D Levels for Early Cardiovascular Risk Assessment in Primary Sjogren’s Syndrome

Introduction: Sjogren’s is an autoimmune disease that affects several organs, especially the heart, and raises cardiovascular risk. Investigating associations of hemoglobin-to-RDW ratio (HRR), vitamin D status, and cardiac function could provide valuable insights and biomarkers regarding early cardiovascular risk in patients with SD. Method: This cross-sectional study involved 61 patients diagnosed with primary Sjogren’s syndrome (pSS) based on ACR/EULAR criteria. Data on demographics, hematological (Hb, RDW), echocardiography, and serum vitamin D levels were collected. Echocardiograms were conducted by trained cardiologists following established guidelines, while vitamin D levels were measured using ELISA, and statistical analyses, including univariate linear regression, were adjusted for confounders. were performed with SPSS in order to identify whether HRR tertiles were related to cardiac function and vitamin D status. Results: A study of 61 Sjogren’s disease patients (mean age 59.8 years, 89% female) revealed that patients with a lower hemoglobin-to-RDW ratio (HRR ≤0.98) had significantly higher pulmonary artery pressures (PAPs) and lower values for the TAPSE/PAPs ratio, contributing to poor right heart function. These associations were particularly strong in patients with insufficient levels of vitamin D (< 30 ng/mL), while differences in other echocardiographic parameters remained nonsignificant between HRR groups. Conclusion: These findings underscore the clinical value of HRR as a composite biomarker that reflects the interplay between anemia, inflammation, and cardiovascular health in Sjogren’s disease. They also suggest that vitamin D status may be an important therapeutic consideration to mitigate cardiopulmonary risks in this population.